Individual provider Active NPI

Jennifer Dykhouse, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1922562040
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801080232 Issued in MI
Practice address
75 Sheldon Ave SE Ste 101
Grand Rapids, MI 49503-4224
Phone
(616) 391-2420
NPI assigned
Jan 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801080232 MI Primary

Addresses

Primary practice location

75 Sheldon Ave SE Ste 101
Grand Rapids, MI 49503-4224

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Jennifer Orr Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190212002225 MI Practitioner - Clinical Social Worker 6204174519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

75 Sheldon Ave SE
100 Corewell Health Medical Group West
Grand Rapids, MI 49503-4224
Phone (616) 391-6120

75 Sheldon Blvd
101 Corewell Health Medical Group West
Grand Rapids, MI 49503-4224
Phone (616) 391-2420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Feb 18, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Feb 18, 2019 Accepting new patients
Spectrum Health Primary Care Partners Past Accepting new patients

Locations

75 Sheldon Ave SE
Ste 101
Grand Rapids, MI 49503
Phone (616) 391-2420

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

75 Sheldon Ave SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 391-2420

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1922562040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SHELDON AVE SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034224",
            "telephone_number": "616-391-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKHOUSE",
        "first_name": "JENNIFER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801080232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ORR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.